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TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIVISIONDATE_
The undersigned applies for the construction of a particular sewer connecting No..f?".z./Z'5~(?'d'7
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of
Sewers,as now or at any future time established by the Board of Selectmen.
Am't.of Estimate $,_
Am't.Paid $_
_Owner
•
Sketch of Service Here 4.A •
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'R ~R .....
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Connection made in Street.
Remarks:
Work completed _19
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